Medical qualifications

“We have a major public safety problem and we haven‘t corrected it.” -Gerald Donaldson, senior research director at Advocates for Highway and Auto Safety, as quoted by the Associated Press.

By now, I‘m sure, you‘ve heard about the big Associated Press story, entitled “Medically unfit drivers still on the road,” published yesterday in a variety of places, such as on CNN‘s news website and a host of newspapers like the Kansas City Star, Connecticut Post, and many others. We also covered it in the news section of our website as well.

The story revolves around an as-yet unreleased Government Accountability Office (GAO) study, which found some 563,0000 U.S. commercial driver‘s license holders also qualify for full federal disability payments due to health issues - with many suffering from severe problems such as seizure disorders, vision and hearing impairment, and the like.

The GAO‘s review of 7.3 million commercial driver violations compiled by the Dept. of Transportation in 2006 showed truck drivers violating federal medical rules in all 50 states, with the most frequent sanctions occurring in Texas, Maryland, Georgia, Florida, Indiana, Pennsylvania, Illinois, Michigan, Alabama, New Jersey, Minnesota and Ohio.

It‘s been a problem for a while, this issue of getting medically unfit drivers off the road, one exacerbated by (of course) politics. The Federal Motor Carrier Safety Administration (FMCSA) finalized mandatory standards for entry-level CDL holders back in 2004, standards that included medical qualifications as well as drug and alcohol testing, under the-chief administrator Annette Sandberg.

“What we are looking at is how we can translate medical data into standards that help improve safety on the highway,” she said at the time. “Now, we are not sure how this effort will pan out, but we do know conditions like fatigue not only have an impact on the health of a driver but on their capability to operate a vehicle. What‘s clear is that we have to look at the driver as a key component of the overall truck - that we have to look at ways of improving their performance and capability so that, by extension, we improve truck safety.”

(Image courtesy of Arab Cartage & Express, Arab, Alabama. These guys are dealing with the health issue pretty smartly, if you ask me. Arab offers Blue Cross/Blue Shield health insurance to its drivers, along with many other insurance benefits at group discounts, including a Merrill Lynch 401 (k) retirement plan with many investment options and company matching. One sure way to improve driver health: more home time. Arab's drivers are home at least once a week, the company says, and sometimes more. They also provide annual paid vacations and 8 paid holidays per year.)

But here we are, again dealing with the issue of medical qualifications, because, well, nothing‘s been done since 2004. Why, you ask? Well, for starters, FMCSA has a LOT of rules and regulations its been trying to get done at the behest of Congress and others (hours of service, anyone?) and anytime you develop new or improved federal regulations, they must go out for public comment, revision, etc. - not including the time needed to deal with lawsuits filed by third parties against proposed rule changes.

One average, it takes about two to three YEARS for proposed federal regulations to make it onto the books - and that‘s if everything goes smoothly.

OK, back to driver medical qualifications. This is a very serious issue: it puts not only the driver but those operating on the highway around him or her in physical danger should a medical condition cause said driver to lose consciousness. I‘m totally in favor of making CDLs more restrictive, for all kinds of health issues, for this reason.

The trucking industry, by the way, is well aware of the driver health issue, though it‘s only addressing it in fits and starts (you‘ll hear in more detail about some successful efforts, like Celadon Group‘s “Highway 2 Health” program tomorrow).

The Atlanta, GA-based American Transportation Research Institute (ATRI), a research organization supported by the American Trucking Associations, is trying to raise the awareness about health and wellness among truck drivers as part of its effort to both study and reduce the effects of driver fatigue.

The physical fitness and overall health of the aging truck driver population in the U.S. is a growing concern among industry experts because fitness relates so strongly to job performance, contends Rebecca Brewster, ATRI‘s president & CEO. She and I talked about this issue a couple of years ago and one of the things that gets overlooked in the health debate, she stressed, are the benefits drivers gain for increased physical fitness and health.

“Certainly, the more physically fit and healthy drivers are, the more alert and less fatigued they are,” she explained to me. “Being physically fit also makes them less susceptible to injury as an increased fitness level gives them more body strength and flexibility - critical aspects when loading and unloading trailers, for example.”

Yet the overall prognosis for truck drivers isn‘t good. Brewster noted that, according to recent research, 55% of truck drivers are overweight and more than 50% smoke, compared to national overall averages of 20.9% and 25%, respectively.

This isn‘t a problem just limited to truck drivers, either. According to a report issued a few weeks back by the Centers for Disease Control (CDC), the proportion of U.S. adults who self-report they are obese increased nearly 2% between 2005 and 2007. According to the CDC‘s Morbidity and Mortality Weekly Report (MMWR), an estimated 25.6% of U.S. adults reported being obese in 2007 compared to 23.9% in 2005, an increase of 1.7 percent. The report also finds that none of the 50 states or the District of Columbia has achieved the Healthy People 2010 goal to reduce obesity prevalence to 15% or less.

In three states - Alabama, Mississippi, and Tennessee - the prevalence of self-reported obesity among adults age 18 or older was above 30, with only. Colorado reporting the lowest rate of obesity prevalence at 18.7%. Obesity is defined as a body mass index (BMI) of 30 or above. BMI is calculated using height and weight. For example, a 5-foot, 9-inch adult who weighs 203 pounds would have a BMI of 30, thus putting this person into the obese category, said the CDC.

“The epidemic of adult obesity continues to rise in the U.S. indicating that we need to step up our efforts at the national, state and local levels,” said Dr. William Dietz, director of CDC's Division of Nutrition, Physical Activity, and Obesity. “We need to encourage people to eat more fruits and vegetables, engage in more physical activity and reduce the consumption of high calorie foods and sugar sweetened beverages in order to maintain a healthy weight.”

Yet ATRI‘s Brewster reminded me that while drivers - like the rest of us - must take personal responsibility for eating well and excursing, their work environment isn‘t exactly conducive to those goals. “The stress out on the road, the lack of time to exercise, all contribute to the issue,” she said. “My personal belief is that the industry must do what it takes to support ways to make drivers more fit and healthy - because the bottom line impact for trucking cannot be ignored.”

So as the debate over driver medical qualifications gets started, let‘s remember that there are many positives to be gained from improved physical fitness and health. We need to keep that in mind as the negatives start getting thrown around.